How Tech Redefines Your Doctor’s Appointment

Telemedicine Whether you’re biking to work, or watching a movie at home, tech has changed the way we collect and share personal data with our doctors.

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Galina Datskovsky, Ph.D.

CRM, FAI, CEO, Vaporstream

“I think we will see a far greater push for security, ephemerality and confidentiality protection.”

How would you describe mHealth to someone who’s not an expert?

MHealth is an interesting trend in health care that allows the patient to more actively participate and engage in their care, and also allows other caregivers to be more involved in an easier fashion.

Utilizing mobile technology that is so readily available, patients and care givers can have apps that measure exercise activity, remind them of appointments, check on their weight management progress and even securely text with multiple remote team members as just a few examples. It is a true revolution in how we view health care.

What security measures are in place for these new practices?

HIPAA regulations require security and privacy of protected health information. However, certain information may or a may not fall into the category, such as Fitbit uploads. I think we will see a far greater push for security, ephemerality and confidentiality protection to be built into the applications. I think patients will become much more aware of the dangers of posting and sharing information from their apps in public forums.

What will it take for mHealth to get to the next level?

There really are two main hurdles to adoption: security and ease of use. Ease of use is essential to quicker adoption. Automation of vital information collection and personal data may make it much more palatable. It is also important for the apps to be self-explanatory. No one likes a non-intuitive app. Security and privacy concerns are another major hurdle to adoption. How easy is it to hack the app? Do I want my personal health history to fall into the wrong hands? Assurance of confidentiality and privacy will go a long way to improving adoption.

Roy Schoenberg

CEO, American Well, Creator, Amwell

“It’s literally putting health care in people’s hands and giving them the experience they deserve.”

How would you describe mHealth to someone who’s not an expert?

MHealth, or mobile health, is the ability to access health care whenever you need it, from wherever you are. At home, at work, on the road, in flight—thanks to modern technology you can now see a doctor on-demand or by appointment, from your smartphone or laptop, whenever you need it.

It’s really that simple now, and it’s changing how patients receive their care and how doctors think about delivering care. For example, leading hospital networks, like Cleveland Clinic and Intermountain Healthcare, are adopting telehealth technology and making their own brand of virtual care available to more patients. Now, mHealth is not just about convenient care, but about gaining access to the best doctors and care available.

In the near future, mHealth will expand to become a collection of technologies that dramatically increase the reach of traditional health care. For people, this means that instead of trying to find and schedule the health care you need, it will come to you. For anyone with a new, urgent issue such as a rash or infection, or a chronic condition like diabetes that requires ongoing support, mHealth will soon enable all patients to be cared for from the comfort of home.

In your experience, what have patients been most surprised at when newly adopting mHealth?

That it can be just as good as or better than traditional health care. I think many people approach mHealth technologies like telehealth, which allows you to see a doctor on your phone in mere minute, as a less qualified or less intimate form of regular health care. But that’s not the case.

Any telehealth app that has been accredited by the American Telemedicine Association includes access to U.S. board-certified doctors who have been credentialed and certified to practice online to the highest standards. With the right app, you’re receiving high-quality care from a reputable physician. The doctor will conduct a thorough examination that includes being able to prescribe you treatment if you need it and send it electronically to your local pharmacy, and provide a written report with all the information you need about your diagnosis and treatment.

Plus, because of the face-to-face interaction over video with the ability to share more information like your own surroundings at home, it is a very personal encounter that helps create a sense of trust with that provider. Basically a virtual visit is the modern version of the traditional doctor house visit, an experience that for many can feel better, and more intimate, than going to the doctor’s office.

What security measures are in place for these new practices?

When it comes to protecting patient health information online, security is our number one priority and one we go to great lengths to ensure. Our service, for example, is private, secure and compliant with HIPAA, ensuring visits are safe and confidential. If you’re using mHealth technology, you should make sure that it is compliant with HIPAA and that there is a privacy policy in place; this helps keep your personal medical information between you and your doctor.

If the industry were a pizza pie, what percentage do you foresee telehealth taking over in the future?

Kaiser Permanente recently suggested that virtual visits could replace more than half of all medical care delivered. Much of health care today—urgent care visits, follow-up visits, post-operation visits—could be supported or completely replaced by virtual visits.

Someday, every doctor will use telehealth technology with their patients, and as part of that relationship they will decide on when a visit requires hands-on or in-person evaluation, and when it can be hands-off, or done remotely. mHealth technology is advancing so fast that even during a hands-off examination, you will soon have at-home tools available to you that let a doctor do everything from check your temperature or your blood pressure to your heart rate, all without getting off the couch. It’s really cool.

What will it take for mHealth to get to the next level?

For doctors, it’s how they’ll get paid for doing the things they’ve always done in-person. For patients, it’s embracing a new way of approaching their care, and knowing when they need to get up, get in the car and go into the doctor’s office, or when they can just stay at home and open their laptop. For the industry, it’s the “bad apples” or those sub-par services that either don’t follow quality of care standards or security and privacy measures, or don’t preserve the best parts of the health care experience online, such as being able to see a doctor face-to-face.

The quality of the care people receive should be at the highest standard, always—no matter if it’s offline or online. In short, health care should be no different than booking online travel, or doing online banking or clicking into an app and ordering a car service or book on-demand. Great health care shouldn’t be hard to find or too expensive to afford. And that is what is so exciting about mobile health technology; it’s literally putting health care in people’s hands and giving them the experience they deserve.

Christian Reilly

Connected health is a promising and transformative set of programs and technologies that enables patients to self-manage their own health and engage with clinicians in a more personal way. Telehealth, patient portals, mobile apps, online clinical tools, wearables—among other connected devices—give patients the information they need to see a personal picture of their well-being while arming doctors with health records that are far more accurate and complete than ever before. The result: better patient-doctor communication, better health care decisions, and better overall health.

In your experience, what have patients been most surprised at when newly adopting connected health?

Patients who are new to connected health tend to be pleasantly surprised by the depth and breadth of information that comprises their medical history. However, while having a comprehensive view can help them to take proactive wellness strategies and make decisions, it also can be somewhat daunting. Terminology, visuals, consent forms, disclaimers and other data can create information overload and introduce more questions than answers.

What security measures are in place for these new practices?

Most connected health opportunities require patients to “opt in.” By doing so they are granting permission for their doctors to communicate through these channels. Patient portals, mobile apps, telehealth programs and the like adhere to basic principles outlined in HIPAA guidelines and require security authentication from patients. With the evolving security landscape, you can expect that more stringent requirements will be implemented to prevent security breaches and misuse of innovative, emerging technologies, such as wearables and implantables.

If the industry were a pizza pie, what percentage do you foresee telehealth taking over in the future?

Connected health is beginning to take hold but is still maturing as providers and patients grapple with how to measure the value of patient care. Today, we think of connected health in terms of channels and devices that deliver information. In the future, connected health tools will play a routine role in everyday care as the standard for self-care and just-in-time care.

What will it take for mHealth to get to the next level?

Patients place a huge degree of trust in their doctor, however they are equally concerned about their privacy. Patients and clinicians will need to share responsibility for securely managing the flow of data between themselves, devices, sensors and apps. Both will have a stake in gaining valuable, actionable insights that drive better decisions and better overall health.

Harry Wang

Senior Research Director, Parks Associates

“Imagine yourself in control of how you manage your personal health and well-being, and being able to do so with confidence.”

How would you describe mHealth to someone who’s not an expert?

Imagine yourself in control of how you manage your personal health and well-being, and being able to do so with confidence and ease. You’ll also have a carefully chosen support team, ranging from your family and friends to your doctors, who encourage you and guide you toward fulfillment of your long- and short-term health goals. That’s the promise of connected health.

In your experience, what have patients been most surprised at when newly adopting connected health?

Consumers are either delighted to find that connected health tools inform them of things they never noticed or didn’t know impacted their health, or they are disappointed because the promise of ease and benefits does not materialize. In the former case, for complex conditions such as diabetes and sleep problems, the discovery of things that can help consumers better cope with such conditions is of tremendous value to them and the health care industry.

In the latter case, everyone has expectations regarding the promise of connected health, but consumers should be informed that connected health tools are assisting consumers improve this health; they are not a magic pill. Over time, connected health solutions will gradually improve to meet consumers’ expectation.

What security measures are in place for these new practices?

The best security has to include educating consumers. Security is always a competition between attack and defense. We have faith that good technologies will be a few steps of ahead of bad guys but, at the same time, security is most vulnerable from the inside. So the best security is not only the most advanced encryption but also the education of end users and auto detection of vulnerabilities so that connected health has the best possible protection against thieves and malicious hackers.

If the industry were a pizza pie, what percentage do you foresee telehealth taking over in the future?

If the pie is about whether the health care industry will be digitally connected, then connected health is the whole pie because connectivity in health care will blanket all areas of care delivery, from in-patient operation to outpatient visits to home care. But I would rather view connected health solutions as the oven for the pizza—fine-tuned tools that help create the best consumer experience in health care, just like a smart oven produces the best pizza.

What will it take for mHealth to get to the next level?

Consumer experience. This is the hurdle for the connected health industry, because as the health care industry shifts to value-based care, and as care models allocate more resources to preventive care, behavioral changes are the key to their success. We can create new CPT codes, offer upfront incentives for doctors to provide more education, coping and coaching, and develop the most advanced connected health solutions, but if the patient experience is poor and usage and engagement levels are low, the outcome will disappoint.

This is a challenge not only for the tech industry but for the care community overall. The current positive collaboration between the tech and health care communities gives us great hope this hurdle can be overcome in the near future.

Brad Brooks

Co-Founder & CEO, TigerText

“The next hurdle is to standardize health care communication practices across the industry.”

How would you describe mHealth to someone who’s not an expert?

Connected health holds enormous promise in advancing the speed and quality of patient care. Today, most patient data is housed in a computer-based medical records system, making it difficult for roaming physicians and nurses to access. Layer in outmoded norms like pagers and faxes, and you add even more drag and cost to the system. Connected health starts by leveraging smartphones and mobile connectivity so care teams have a secure, instant pipeline to patient data, accelerating the speed and quality of care, leading to lower costs and happier patients.

In your experience, what have patients been most surprised at when newly adopting connected health?

For most patients, the initial surprise comes when they realize how much faster their hospital stay is compared to past visits. In a facility that has fully embraced connected health, every stage of the patient’s stay is accelerated, from admissions and discharges, consults with specialist, lab results, imaging, surgical procedures, medication reconciliation and follow-up scheduling. Everything happens faster, so patients can leave the facility with a care plan in place and a post-care team ready and informed, helping them get back on the road to recovery faster.

What security measures are in place for these new practices?

Since compromised patient records fetch 10 to 20 times more than a stolen credit card number, protecting patient data is both a legal and moral imperative. Complying with the Health Information Portability and Accountability Act regulations ensures patient records are kept safe, but more can be done. For example, health care text messaging apps must offer encryption and security protections with policies and administrative oversight that limits records access to a patient’s immediate care team.

If the industry were a pizza pie, what percentage do you foresee telehealth taking over in the future?

Building on the pizza analogy, a better way to look at it would be viewing connected health as the crust of the pizza, the foundation upon which information (e.g. cheese, sauce and toppings) is accessed and exchanged across the system. This includes insurance providers, hospital teams, primary care physicians and other roles and where the patient is located at the center of the entire process.

What will it take for mHealth to get to the next level?

The next hurdle is to standardize health care communication practices across the industry, by aligning them to the everyday workflows associated with patient care. This is clearly the path forward. Aggregating information from various systems and sources into a single application on a smartphone or tablet is guaranteed to improve the quality of care, drive down costs and give patients a real opportunity to actively participate in their own care.

Phil Gaziano

Chief Data Officer, Physicians Accountable Care Solutions, LLC

“It’s important to have a check in place that ensures that anyone who has access to information is relevant.”

How would you describe mHealth to someone who’s not an expert?

Provider working together to achieve the Triple Aim and pay attention to the many different connections between episodes of care for their patients and their population.

In your experience, what have patients been most surprised at when newly adopting connected health?

That their provider knows what happens to them when they’re not in the office, or not being cared for by their provider.

What security measures are in place for these new practices?

It’s important to have a check in place that ensures that anyone who has access to information is relevant and has a role in caring for the individual, so that information isn’t share unnecessarily. Outside of them, I’m all for sharing information to improve efficiency and have access to the whole picture, even if it shakes up some legacy red tape.

If the industry were a pizza pie, what percentage do you foresee telehealth taking over in the future?

The data and analytics connections will make up about 10 percent of the pie. Primary care should be 20 percent and half of that should be focused on data sharing and connected, coordinate care. The management piece of the pie should shrink more than the connected technology piece grows, and therefore create a new piece of pie for the consumers of health care.

What will it take for mHealth to get to the next level?

The biggest hurdle will be breaking down the “proprietary” and business limitations that prevent information from flowing freely. Regulators have a role: to step in and say information should be shared if it is contributing to a broader social good.

I recognize this is a sacrifice for the companies that have built their business on these pieces of information and that use them to fuel their own innovation a growth. But to achieve the Triple Aim in any meaningful way, the most basic building blocks, or the data points that occur, should be open source for everyone to then create solutions from. It is a change, and I know I would think differently if I were running an EMR vendor, for instance, but even they will adapt and thrive over time.

Ben Kraus

President, Quality Health Ideas, Inc.

“The value is evident to most, the sensitivity and security is the flip-side of the coin that needs to be rock-solid.”

How would you describe mHealth to someone who’s not an expert?

Connected health is providing better medical solutions to more people, leveraging technology to make it happen. It can be as obvious as virtual visits to primary care physicians using a smartphone, to as inconspicuous as finding new ways to look at data across a large population over a long period of time. The ultimate end result is advancement of care to people that need it.

In your experience, what have patients been most surprised at when newly adopting connected health?

Patients tend to be surprised that we are able to access past medical information that even they had forgotten about, or did not fully understand, to implement care by our physician network. Many patients are very accustomed to some of the inadequacies and challenges of disconnected health, which is exciting, because we are supercharging their experience and there is plentiful opportunity for improvements.

What security measures are in place for these new practices?

While we provide value-adding services to improve care and lower unnecessary cost, we can only do so as long as we maintain absolute data security. We maintain a Data and Information Security Team dedicated to advancing our corporate policies and enforcement of protective measures, because social engineering is often the biggest threat to data security.

If the industry were a pizza pie, what percentage do you foresee telehealth taking over in the future?

The whole pie. It’s only a matter of time, and I’m excited to see the benefits it will bring. QHI will be only one of thousands of companies offering better care in a connected health world.

What will it take for mHealth to get to the next level?

The biggest challenge is the adoption curve, and more specifically, avoiding big news incidents that slow down the adoption rate. The value is evident to most, the sensitivity and security is the flip-side of the coin that needs to be rock-solid in order to facilitate expansion and delivery of that value.

Feli Thurmayr

Chair and Chief Medical Officer, Quality Health Ideas, Inc.

“One could argue that 50 percent of providers are connected somehow already.”

How would you describe mHealth to someone who’s not an expert?

Connected care is a necessary approach to provide the right data to all health care providers, and any efforts to connect dis-integrated data points that are currently all over the place is a positive movement. Also, changing mindset from acute care to preventative care, which is absolutely necessary but cannot be done without all of the right data.

In your experience, what have patients been most surprised at when newly adopting connected health?

That providers have the capabilities to access and leverage a wealth of data. Most don’t realize that the status quo isn’t good enough, and are surprised by benefits that they should have expected all along.

What security measures are in place for these new practices?

We need the proper protocols for the right users to define who should and has access and the right security it control and know who is using the tools or data, to execute and maintain security.

If the industry were a pizza pie, what percentage do you foresee telehealth taking over in the future?

One could argue that 50 percent of providers are connected somehow already, with EMRs and claims data flowing. But it's not the right type of connections and only between two or three parties—not pervasive to all relevant and necessary parties. It’s not necessarily providing effective preventative care.

Also availability might be there but frequency is low today. You can view it as 1 percent or 50 percent. I envision penetration and frequency to rise markedly in the near future.

What will it take for mHealth to get to the next level?

The education curve is steep for providers and the receivers and everyone is busy with what they're doing today and change is hard. Also, people follow the big marketing messages, e.g., fancy ads on TV, which are not necessarily the right paths to follow. It's an uphill battle to educate the consumer what is helpful versus not.